WT Cox 2025-2026 Benefit Guide : simplebooklet.com

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2025 - 2026 Cox Subscriptions, Inc.As an employee of Cox Subscriptions, Inc., enjoying your work and making valuable contributions to business are equally vital. The health, satisfaction and security of you and your family are important, not only to your well-being, but ultimately, in terms of achieving the goals of our organization.For the 2025-2026 plan year, Cox Subscriptions, Inc. has worked hard to offer a competitive total rewards package that includes valuable and competitive benefit plans. These programs reflect our commitment to keeping our staff healthy and secure. We understand that your situation is unique, and Cox Subscriptions, Inc. is offering an overall benefits package that can be shaped and molded by you to fit your needs.This benefits booklet is a summary description of your Cox Subscriptions, Inc. benefit plans. If there is a discrepancy between these summaries and the written legal plan documents, the plan documents shall prevail. This booklet and plan summaries do not constitute a contract of employment.We hope this benefits booklet, along with our additional communication and decision-making tools, will help you make the best health care choices for you and your family.INTRODUCTIONEligibility & EnrollmentAs a full-time employee working 30+ hours/week you are eligible for benefits. You can enroll or make changes during our annual enrollment period or within 30 days if you experience a qualifying life event during the year. A Qualifying Life Event includes changes in marital status, employment status, birth or adoption of a child, death of a dependent, entitlement to Medicaid or Medicare, loss of other coverage or eligibility of dependents.Benefits Begin First of month following 60 days of employmentBenefits EndEnd of month of termination (Cancer Indemnity: date of termination)Dependents Legal spouse and dependent children up to age 26Domestic Partner Same and opposite sex

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This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2025 - 2026 Cox Subscriptions, Inc.Comparison of PlansCoverage Provided by UnitedHealthcareIn-NetworkOpen Access Direct HSA EAWO w/ Rx C80Choice PlusOpen Access DRNC w/ Rx 529Choice PlusOpen Access Direct DRPF w/ Rx 529Choice PlusBenefit Period Plan Year: 6/1 – 5/31 Plan Year: 6/1 – 5/31 Plan Year: 6/1 – 5/31Deductibles (Individual / Family)$5,000/$10,000(Family Member: $5,000)$7,500/$15,000 $4,000/$8,000Out-of-Pocket Max (Individual / Family)$6,500/$13,000(Family Member: $6,500)$9,200/$18,400 $7,500/$15,000Preventive Care Covered at 100%** Covered at 100%** Covered at 100%**Primary Care Visit 20% after deductible$25 Copay ($0 Copay if less than age 19)$30 Copay ($0 Copay if less than age 19)Specialist Visit 20% after deductible $50 Copay after deductible $60 CopayTelehealth 0% after deductible $0 Copay $0 CopayUrgent Care 20% after deductible $50 Copay $50 CopayEmergency Room 20% after deductible$500 Copay after deductible30% after deductibleInpatient Visit 20% after deductible$2,500 Copay per day after deductible (Up to a max $7,500 Copay)30% after deductibleOutpatient ProcedureAmbulatory surgical center: 20% after deductibleHospital-based surgical center: $500 per occurrence deductible, then 20% after deductible$500 Copay afterdeductibleAmbulatory surgical center: 30% after deductibleHospital-based surgical center: $500 per occurrence deductible, then 30% after deductibleAdvantage FormularyPharmacy / RX (30 Day Supply)20% after deductible $10/$35/$75/$150 $10/$35/$75/$150MEDICALThe chart below is an overview of the In-Network benefits. Out-of-Network benefits are available; please review your UnitedHealthcare plan documents for additional details.**Preventive care services mandated under the Affordable Care Act (ACA) are covered at 100%. If additional routine services are needed, charges may apply.

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This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2025 - 2026 Cox Subscriptions, Inc.Wellness and Health ManagementUnderstanding the full value of covered benefits allows you to take responsibility for maintaining good health and incorporating healthy habits into your lifestyle. Some examples include getting regular physical examinations, mammograms and immunizations. Through the plans offered by Cox Subscriptions, Inc., all covered individuals and family members are eligible to receive routine wellness services like these, at no cost; all copays, coinsurance, and deductibles are waived.Which Preventive Care Services Are Covered?The US Preventive Services Task Force maintains a regular list of recommended services that all Affordable Care Act (i.e., Health Care Reform) compliant insurance plans should cover at 100% for in-network providers. Below is a list of common services that are included in the plans offered this year:• Routine physical exam• Well baby and childcare• Well women visits• Immunizations• Routine bone density test• Routine breast exam• Routine gynecological exam• Screening for Gestational diabetes• Obesity screening and counseling• Routine digital rectal exam• Routine colonoscopy• Routine colorectal cancer screening• Routine prostate test• Routine lab procedures• Routine mammograms• Routine pap smear• Smoking cessation• Health education/counseling services• Health counseling for STDs and HIV • Testing for HPV and HIV• Screening/counseling for domestic violencePREVENTIVE CAREPricing Per Pay PeriodOpen Access Direct HSA EAWO w/ Rx C80Open Access DRNC w/ Rx 529Open Access Direct DRPF w/ Rx 529Employee $62.45 $124.95 $171.42Employee + Spouse $496.46 $560.74 $665.46Employee + Child(ren) $378.72 $428.91 $507.02Employee + Family $828.90 $915.34 $1,073.71Your Bi-Weekly Cost (26 Deductions) Your cost for coverage is deducted on a pre-tax basis from each paycheck.

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Plan Management | Care CashHow to use Care Cash to help you make the most of itCare Cash® is a preloaded debit card that helps you pay for cost-effective* and convenient care. Use it in place of a credit or debit card to help pay toward cost-sharing for the following program eligible network** expenses listed below.To get the most from your Care Cash card, use it only for eligible, network expenses outlined in this document. Some examples of expenses NOT eligible for Care Cash include:• Prescription drugs • Dental or vision care service providers • Emergency room care service facilities• Personal purchases (general merchandise, groceries, etc.)Questions about eligible program expenses? Call the toll-free number on your health plan ID card.UnitedHealth Premium® Care ProvidersThe UnitedHealth Premium program can help you find providers who meet criteria for safe, timely, effective and efficient quality care. When searching for a primary care provider or specialist on myuhc.com®, look for the 2 blue hearts near the doctor’s name. If you are on a Tiered medical plan, look for providers with a Tier 1 blue dot. Primary care** – A primary care provider (PCP) is the first person you call with medical questions and issues to help guide you to the care you may need — from physical to behavioral health. They may help you avoid surprise costs, save time and make the best use of your health care. Specialty care – A specialist provider focuses on a specific area of complex care — from cardiology to orthopedics.Urgent careUrgent care clinics offer treatment for non-life-threatening injuries or illnesses, like sprains and minor burns. These clinics are staffed by physicians and care teams.LabOutpatient Lab and laboratory providers support the diagnosis, treatment and follow-up of clinical conditions, as well as a variety of specialized services.24/7 Virtual Visits When you need care — anytime, day or night — 24/7 Virtual Visits may be a convenient option. You can connect with a provider through your mobile device,*** tablet or computer and get treatment for allergies, headaches, rashes and more — from wherever you are.Learn moreVisit myuhc.com/carecash *Not all providers for which you can use your Care Cash card have been assessed for cost-efficiency. **Must be a UnitedHealthcare Network provider to be eligible for Care Cash.***Data rates may apply.continued

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Plan Management | Care CashCare Cash® is a preloaded debit card that helps pay toward cost-sharing for certain eligible network health care expenses.*continuedFollow these 5 steps to get your card 1Go to myuhc.com® > Coverage & Benefits. If you haven’t yet registered at myuhc.com, you’ll need to do that first.2Scroll to the Care Cash section and select the Request card button.3Once you’re on the Care Cash page, select the Request card button.How to request your Care Cash card* Must be a UnitedHealthcare Network provider to be eligible for Care Cash.Care Cash is already part of your plan. Get your card today.Introducing Care Cash, a preloaded debit card that helps you pay for eligible network care expenses.

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Care Cash provides a pre-loaded debit card which can be used for certain health care expenses. If the card is used for ineligible 213(d) expenses, individuals may incur tax obligations and should consult an appropriate tax professional to determine if they have such obligations. The information provided in connection with Care Cash is for general informational purposes only and is not intended to be nor should be construed as medical advice. Individuals should consult an appropriate health care professional to determine what may be right for them.24/7 Virtual Visits is a service available with a Designated Virtual Network Provider via video, or audio-only where permitted under state law. Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. 24/7 Virtual Visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times, or in all locations, or for all members. Check your benefit plan to determine if these services are available.The UnitedHealth Premium® designation program is a resource for informational purposes only. Designations are displayed in UnitedHealthcare online physician directories at myuhc.com®. You should always visit myuhc.com for the most current information. Premium designations are a guide to choosing a physician and may be used as one of many factors you consider when choosing a physician. If you already have a physician, you may also wish to confer with him or her for advice on selecting other physicians. You should also discuss designations with a physician before choosing him or her. Physician evaluations have a risk of error and should not be the sole basis for selecting a physician. Please visit myuhc.com for detailed program information and methodologies.Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates.B2C EI211079513.3 10/23 © 2023 United HealthCare Services, Inc. All Rights Reserved. 23-2730957Questions?Call the toll-free number on your health plan ID card4Follow the prompts to verify your address and contact info or make any required updates. When you’re finished, select the Request card button. 5Make sure you get the confirmation message. When you do, you’ll know your request is complete.Once you receive your card, there’s one final stepAfter completing your request, your card should arrive by mail within 7–10 business days. You’ll need to activate it, which you can do by calling the toll-free phone number that’s listed on the card sticker.

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3Once you’re on the Care Cash page, select the Reload your card now button. 4Follow the prompts to verify your address and contact info or make any required updates. When you’re finished, select the Reload now button. 5Make sure you get the confirmation message. When you do, you’ll know your request is complete. Your new balance will be available within 48 hours. You may continue to use your existing card. Care Cash provides a pre-loaded debit card which can be used for certain health care expenses. If the card is used for ineligible 213(d) expenses, individuals may incur tax obligations and should consult an appropriate tax professional to determine if they have such obligations. The information provided in connection with Care Cash is for general informational purposes only and is not intended to be nor should be construed as medical advice. Individuals should consult an appropriate health care professional to determine what may be right for them.Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates.B2C EI211165388.0 10/21 © 2021 United HealthCare Services, Inc. All Rights Reserved. 21-1078711-BQuestions?If you need a replacement card, call 1-888-201-4286

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$0 cost for certain medications*We’re making medications that may be essential to your health more affordable. The new UnitedHealthcare Vital Medication Program offers certain drugs at no additional cost.* This means there may be no out-of-pocket costs for preferred insulins and certain other medications, including: Insulin – rapid, short and long-acting Epinephrine – allergic reactions Glucagon – hypoglycemia (low blood sugar) Naloxone – opioid overuse Albuterol – asthmaTo see if you’re eligible for no out-of-pocket costs on preferred insulins and other prescription drugs, sign in to myuhc.com/rx*Available to eligible members. Check your coverage details at myuhc.com/rx.If you are not currently enrolled with UnitedHealthcare pharmacy benefit coverage, you may access your health plan’s member website for additional information during your open enrollment period or you may contact your employer or health plan for additional information. Medications are categorized by common therapeutic conditions in this reference guide for ease of reference only. These categories do not determine coverage for the medication for your condition. Your benefit plan determines how these medications may be covered for you. Where differences are noted between this reference guide and your benefit plan documents, the benefit plan documents will govern. This document applies to commercial group members of UnitedHealthcare plans.Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc. or their affiliates, and UnitedHealthcare Service LLC in NY. Health plan coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Stop-loss insurance is underwritten by All Savers Insurance Company (except CA, MA, MN, NJ and NY), UnitedHealthcare Insurance Company in MA and MN, UnitedHealthcare Life Insurance Company in NJ, UnitedHealthcare Insurance Company of New York in NY, and All Savers Life Insurance Company of California in CA. Optum Rx® is an affiliate of United HealthCare Insurance Company.B2C EI221991400.0 12/22 © 2022 United HealthCare Services, Inc. All Rights Reserved.

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This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2025 - 2026 Cox Subscriptions, Inc.This Is How An HRA Works• To help offset your out-of-pocket medical costs, Cox Subscriptions, Inc. has set up a Health Reimbursement Arrangement (HRA) for you to utilize. • An HRA is an employer funded account that can help pay for qualified medical expenses. On the HRA with Cox Subscriptions, Inc., qualified medical expenses are defined as deductible and office visits copays.• All full-time employees enrolled on the medical plan with Cox Subscriptions, Inc. are eligible to utilize the HRA funds.Eligible ExpensesOnly eligible expenses can be reimbursed under your HRA. These expenses are defined by the IRS rules and by the Cox Subscriptions, Inc. plan. Learn more about eligible HRA expenses by reading the Summary Plan Description (SPD).When To Submit For ReimbursementOnce you meet the thresholds outlined in the plan, you can submit for reimbursement. Cox Subscriptions, Inc. will fund the HRA with $750 for Employee Only and Employee + Spouse Coverage, and $1,000 for Employee + Child(ren) and Family Coverage on the copay and HDHP plans. You’re eligible for reimbursement from the HRA for deductible and office visit copay expenses.Employees electing the HDHP/HSA qualified plan can only be reimbursed for expenses after they have met their deductible. Once you meet your deductible, contact Allison Thompson for details.HEALTH REIMBURSEMENT ACCOUNT (HRA)Coverage Level Cox Subscriptions, Inc. ReimbursesEmployee $750Employee + Spouse $750Employee + Child(ren) $1,000Employee + Family $1,000How To File A Claim1. Incur an eligible expense and obtain an Explanation of Benefits (EOB) for the expense. 2. Submit your reimbursement request directly through your HealthEquity member portal.For additional assistance, please contact member services at 866-346-5800, available 24/7.Refer to your HRA documentation for more details.

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This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2025 - 2026 Cox Subscriptions, Inc.A health savings account (HSA) is a health care account and savings account in one. HSA helps offset the cost of a HDHP while saving for your out-of-pocket eligible health care expenses. The HSA is your personal bank account and can be used for you and your dependents now and in the future.Why Is It A Good Idea To Have An HSA?HSAs benefit everyone who are eligible to have this account, including single individuals, families and soon-to-be retirees. You save money on taxes in three ways:• Tax-Free Deposits: The money you contribute to your HSA isn't taxed (up to the IRS annual limit)• Tax-Free Earnings: Your interest and any investment earnings grow tax-free• Tax-Free Withdrawals: The money used toward eligible health care expenses isn't taxed now or in the futureSetting aside pre-tax dollars into your HSA means you pay fewer taxes and increase your take-home pay by your tax savings. You save money on eligible expenses that you are paying for out of your pocket. The amount you save depends on your tax bracket. For example, if you are in the 30% tax bracket, you can save $30 on every $100 spent on eligible health care expenses.HSA funds roll over from year to year and accumulate in your account. There is no "use-it-or-lose-it" rule with HSAs, and you decide how and when to use your HSA funds, which can be used for eligible expenses you have now, in the future, or during retirement. Also, when you have a certain balance in your HSA, investment opportunities are available.Who is Eligible?You are eligible to contribute to an HSA if:• You are enrolled in a qualified HDHP• You are not enrolled in a copay plan such as a spouse’s non-HDHP, Medicare, Medicaid or Tri-Care• You or your spouse is not enrolled in a full purpose Health Care Flexible Spending AccountRefer to your HSA documentation for more details.HSA Contribution LimitsYou can contribute to your HealthEquity HSA on a pre-tax basis through payroll deductions up to the IRS statutory maximums. The IRS has established the following maximum HSA contributions:2025 Tax Year$4,300 Individual / $8,550 FamilyIf you are age 55 and over, you may contribute an extra $1,000 catch-up contribution. HEALTH SAVINGS ACCOUNT (HSA)

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This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2025 - 2026 Cox Subscriptions, Inc.This Is How An FSA Works:• You set aside money for your FSA from your paycheck before taxes are taken out.• You then use your pre-tax FSA funds throughout the plan year to pay for eligible health care or dependent care expenses.• You save money on expenses you're already paying for.You can elect up to $3,300 for the 2025-2026 plan year. Our plan through Ameriflex offers a carry over up to $660 of unused funds to the following year. Health FSA Eligible Expenses• Medical expenses: copays, coinsurance and deductibles• Dental expenses: exams, cleanings, X-rays and braces• Vision expenses: exams, contact lenses, eyeglasses and laser eye surgery• Professional services: physical therapy, chiropractic and acupuncture• Prescription drugs and insulin• Over-the-counter health care items such as bandages, pregnancy tests and blood pressure monitorsIf enrolled in a HDHP with an HSA, you can enroll in a limited purpose FSA. Limited Purpose Health FSA Eligible Expenses• Dental expenses: exams, cleanings, X-rays and braces• Vision expenses: exams, contact lenses, eyeglasses and laser eye surgeryDependent Care FSA Eligible Expenses• Care for your child who is under the age of 13• Before-school and after-school care• Babysitting and nanny expenses• Day care, nursery school and preschool• Summer day camp• Care for a relative who is physically or mentally incapable of self-care and lives in your homeRefer to your FSA documentation for more information. FLEXIBLE SPENDING ACCOUNT (FSA)

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This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2025 - 2026 Cox Subscriptions, Inc.Summary of CoverageCoverage provided by PrincipalPlan Features Voluntary Short-Term Disability Voluntary Long-Term DisabilityEmployee Benefit Amount 60% of Covered Earnings 60% of Covered EarningsMaximum Benefit Amount $1,000 / weekly $2,500 / monthlyElimination Period 7 days accident / 7 days illness 180 daysBenefit DurationUp to 26 weeks(Includes Elimination Period)SSNRACoverage Paid By Employee EmployeeTaxation Benefit is not taxed Benefit is not taxedDisability insurance is coverage that provides you with income protection should you be unable to work due to an injury or illness. With disability coverage, you are compensated for a portion of your lost income. Short-Term disability provides coverage in the near term, while Long-Term coverage is available for extended disabilities. DISABILITY INSURANCEPlease note, a pre-existing condition period may apply once you become covered. EOI may be required if you enroll as a late entrant. Please review your plan documents for additional details.Cost for Voluntary Long-Term Disability is age-banded. Please see Employee Navigator for your per pay period cost.EMPLOYEE ASSISTANCE PROGRAM (EAP)Our Employee Assistance Program through Principal provides you and your family access to free, confidential resources to help handle life’s everyday challenges. Services for you and your family include: • Up to 3 counseling sessions per year (in-person or virtual)• Legal, financial, and identity theft services • Work-life web services • And more 800-450-1327 https://member.magellanhealthcare.com/ Enter Program Name: Principal Core

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This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2025 - 2026 Cox Subscriptions, Inc.Voluntary Benefits are offered to assist employee's personal insurance needs. These programs are designed to fill the gaps in coverage such as your deductibles and co-insurance under your major medical. Please review your plan documents for additional details.WORKSITE BENEFITSCoverage provided by Principal AccidentPays a lump sum benefit if you or a covered family member experience an accident. Coverage can be purchased for employee and dependents. Wellness Benefit: If you or your covered dependent has a covered screening test performed, you each may receive a $50 benefit, once per calendar year. Make sure to file your claim within a year of the date of service. See carrier document for additional details.Pricing Per Pay PeriodEmployee $4.59Employee + Spouse $7.52Employee + Child(ren) $8.46Employee + Family $13.30Your Bi-Weekly Cost (26 Deductions)Critical IllnessPays a lump sum benefit if you or a covered family member are diagnosed with one of the covered conditions. Health Screening: You may receive a $50 benefit for each covered person who has an eligible health screening test performed, once per calendar year. Make sure to file your claim within a year of the date of service. See carrier document for additional details.Plan Features Employee Spouse Child(ren)BenefitSelect a benefit in increments of $5,000Select a benefit in increments of $2,500Automatically covered for 25% of employee benefit Guaranteed Issue(Newly Eligible Employees)$15,000 $7,500Maximum $50,000$25,000 up to 50% of employee benefitCost is age-banded; please see Employee Navigator for your per pay period cost. Your cost for Accident & Critical Illness coverage is deducted on a pre-tax basis from each paycheck.

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This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2025 - 2026 Cox Subscriptions, Inc.Voluntary Benefits are offered to assist employee's personal insurance needs. These programs are designed to fill the gaps in coverage such as your deductibles and co-insurance under your major medical. Please review your plan documents for additional details.WORKSITE BENEFITS (Continued) Coverage provided by SunLifeCancer IndemnityProvides a fixed benefit for the early detection, incidence and treatment of cancer as well as related expenses. Level 2 provides a greater range of benefits such as reconstructive surgery and immunotherapy. Coverage can be purchased for employee and dependents. Cancer Screening: You may receive a $50 or $75 benefit (depending on plan option selected) if you have a colonoscopy, CA 125 test, chest x-ray, flexible sigmoidoscopy, mammogram, pap smear, biopsy, PSA, CT scan or MRI scan, BRCA testing, or Hemocult stool specimen. This benefit is limited to once per benefit year. See carrier document for additional details.Cost for Cancer Indemnity coverage is age-banded and based on issue age. Spouse and child(ren) rates are based on the employee’s age at the time dependent coverage is elected. Please see Employee Navigator for your per pay period cost. Coverage provided by LegalShield and IDShield Legal and ID TheftProvides legal care for divorce, traffic ticket defense, document review, etc. This benefit includes identify theft solutions. Please see Employee Navigator for your per pay period cost. For more information related to the Legal and ID Theft plans, contact your LegalShield Advisor: Ruth Anderson919-631-2118ruthanderson@rneshield.com Your cost for coverage is deducted on a pre-tax basis from each paycheck.

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WT Cox 2025-2026 Benefit Guide

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